{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:13:20Z","timestamp":1788394400030,"version":"build-2803163510"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Ambient clinical documentation tools are increasingly used to reduce administrative burden and improve provider experience. However, evidence describing their effects at scale across large, multisite health systems remains limited.<\/jats:p>\n                  <jats:p>Objectives The objective of this study is to evaluate the effect of Dragon Ambient eXperience (DAX) Copilot on documentation efficiency, note composition practices, and provider well-being across a multistate health system.<\/jats:p>\n                  <jats:p>Methods Due to rolling registration and training, we conducted a retrospective index-date-aligned pre\u2013post analysis of objective electronic health record activity metrics, supplemented by a postimplementation survey. Physicians and advanced practice providers in ambulatory settings between June 2024 and November 2025 were included. Epic Signal data were analyzed for each provider over the 8 months before and after DAX activation. Metrics included active time in notes per appointment, proportion of note content originating from manual typing, copy\/paste, or conventional voice recognition, and average note length. Surveys were administered 45 days postactivation to assess satisfaction, burnout, intent to remain with the organization, and work\u2013life balance.<\/jats:p>\n                  <jats:p>Results A total of 210 providers met the inclusion criteria, defined as generating \u226525% of total note content using ambient voice technology and having at least 16 months of Signal Data (8 months pre- and 8 months postintervention). Compared with the preimplementation period, active note time decreased significantly (5.54\u20134.09 min per appointment; 26.2% reduction; p &lt; 0.001). Despite a +28.8% increase in note length, manual documentation behaviors declined substantially, including typing (\u221251.7%), copy\/paste (\u221242.7%), and conventional voice recognition (\u221267.8%). Survey responses (n = 233; 26.4% response rate) indicated improvements across domains, with most respondents reporting reduced burnout, increased job satisfaction, improved work\u2013life balance, and a strong preference to continue using DAX.<\/jats:p>\n                  <jats:p>Conclusion Deployment of ambient artificial intelligence documentation technology at scale was associated with improvements in documentation efficiency, substantial reductions in manual input, and improved provider well-being, supporting its potential to meaningfully alleviate documentation burden.<\/jats:p>","DOI":"10.1055\/a-2936-7516","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T23:22:33Z","timestamp":1787181753000},"page":"747-753","source":"Crossref","is-referenced-by-count":0,"title":["Large-Scale Implementation of Ambient Artificial Intelligence Documentation and Its Effects on Electronic Health Record Efficiency and Clinician Well-Being"],"prefix":"10.1055","volume":"17","author":[{"given":"Andrew","family":"Svetly","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["Department of AdventHealth Information Technology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5711-2216","authenticated-orcid":false,"given":"Elie","family":"Razzouk","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["Department of AdventHealth Information Technology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"McLean","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Frye","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Little","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["Department of Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Massaro","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte Springs"],"department":["AdventHealth Medical Group"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheyenne","family":"Quailey","sequence":"additional","affiliation":[{"name":"AdventHealth, Florida, United States","place":["Altamonte 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